Provider Services Representative

Job Description

Job Description

Provider Services Representative

Location: Birmingham, Alabama

Job Summary

The Provider Services Representative serves as the primary contact for the participating provider network in building and maintaining relationships and acts as an advocate for the Health Plan. This position will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy.

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

• Comprehensive Health, Vision, and Dental Coverage
• 401(k) Savings Plan with company match and immediate vesting
• Paid Time Off (PTO)
• 9 Paid Holidays annually plus a Floating Holiday to use as you choose
• Tuition Assistance
• Flexible Spending Accounts
• Healthcare Reimbursement Account
• Paid Parental Leave
• Community Service Time Off
• Life Insurance and Disability Coverage
• Employee Wellness Program
• Training and Development Programs to develop new skills and reach career goals
• Employee Assistance Program

See more about the benefits of working at Viva Health -

Key Responsibilities

• Serve as primary contact for issues between providers and Health Plan developing rapport with established and prospective providers to build business relationships.
• Maintain documentation of provider visits and interactions in database.
• Develop and conduct programs to ensure providers know and understand health plan business policies and practices as described in Policies and Practices.
• Coordinate with other departments to ensure effective communication and/or coordination of efforts concerning provider issues and projects. Complete Provider File Maintenance (PFM) forms to update provider information in computer systems.
• Assist with provider credentialing and re-credentialing efforts.
• Work with Network Development and Marketing and Sales to ensure network adequacy.
• Assist in updating provider-related materials.
• Educate providers and staff on changes to the Health Plan.

REQUIRED QUALIFICATIONS :

• Bachelor’s Degree or equivalent experience in provider relations or similar field
• 2 years’ experience in customer service, marketing, or working with/in a physician’s office
• Proficient in standard Microsoft Office software
• Ability to organize ideas and communicate messages through various mediums including group presentations appropriate to listeners and situations
• Valid driver's license in good standing
• May require significant face-to-face member contact with duties regularly
  performed away from the principal place of business
• Willing to submit to vaccine testing and screening

PREFERRED QUALIFICATIONS:

• Bachelor’s Degree in a health-related field
• 3 years’ experience in insurance claims, physician’s office, customer service, or marketing